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Organization
HEAL THYSELF THERAPEUTICS, LLC
Active
Organization
HEAL THYSELF THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK JEROME JACKSON II LMSW (THERAPIST)
(810) 434-7933
Entity
Organization
Contact information
Practice address
1100 CORPORATE OFFICE DR STE 320, MILFORD, MI 48381-5002
(810) 434-7933
Mailing address
34326 SHERIDAN ST, WESTLAND, MI 48185-8511
(810) 434-7933
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/20/2020
Last updated
12/01/2020
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